Getting transported by ambulance can be a scary and stressful experience. On top of worrying about your medical emergency you may also be concerned about receiving a large ambulance bill that you can’t afford to pay. So do you actually have to pay for ambulance services if you are transported to the hospital?
Unfortunately, in most cases the answer is yes – you are responsible for paying your ambulance bill. However there are some exceptions where you may be able to avoid or reduce the charges. Keep reading to learn more about when you have to pay, steps to take, and ways to potentially lower your ambulance bill.
When Are You Required to Pay an Ambulance Bill?
If an ambulance transports you to the hospital, you will almost always receive a bill for their services. Situations when you must pay include:
- You call 911 and are transported by ambulance after evaluation by EMTs
- Hospital staff or bystanders call an ambulance to transport you
- Transfers between medical facilities by ambulance
Even if you didn’t want or ask for the ambulance, if they provide medical services or transport, you will still receive a bill that you are expected to pay.
However, there are a few exceptions where you may not have to pay the full amount:
- If the ambulance response was unreasonably delayed
- If ambulance services were clearly not medically necessary
- If you were not given a choice and forced to take an ambulance
In these cases, you may be able to negotiate or dispute charges. But these situations are rare, so usually expect to get an ambulance bill.
What Steps Should I Take With My Ambulance Bill?
When you receive an ambulance bill, take the following steps:
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Review the charges: Make sure the amount seems accurate and request an itemized bill if needed. Check for errors.
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Submit to your insurance company: Even if ambulance companies are out-of-network, submit the claim to your insurer. They may cover a portion of the cost.
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Negotiate with the provider: If the bill seems very high, contact them and negotiate for a lower, reasonable amount. Offer to pay quickly at a reduced rate.
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Set up a payment plan: If you can’t afford to pay the full balance, ask to spread payments out over several months. Most ambulance companies will work with you on this.
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Pay with a credit card: This allows you to dispute any unfair charges later. Only do this if you can pay off the balance quickly.
How Can I Potentially Reduce My Ambulance Bills?
If you are facing a high ambulance bill, here are some tips that may help lower the amount you pay:
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Provide proof of financial hardship if you can’t afford the charges. Ambulance companies often lower bills for low-income patients.
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If your insurance denies the claim, appeal the decision if services were medically necessary. Push for them to cover more.
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Ask if the ambulance company offers financial assistance or hardship programs. Some have income-based discounts.
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Negotiate based on rates paid by Medicare or Medicaid, which are usually lower than billed.
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If you were charged excessive mileage, negotiate that down based on standard local rates.
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Ask about community benefit programs if the ambulance provider is a non-profit. They sometimes provide financial assistance.
Answers to Frequently Asked Questions
Below are some common questions about paying ambulance bills:
Do I have to pay the ambulance bill if I have insurance?
Yes, you are still responsible for any portion that your insurance does not cover. Ambulance services are often only partially covered.
What if I flat out refuse to pay or just ignore the ambulance bills?
The ambulance provider may send the unpaid bill to collections, damage your credit, and potentially take legal action against you for the unpaid amount.
Can my income level or financial situation get my ambulance bill waived?
If you provide documentation proving financial hardship, many ambulance companies will significantly reduce or forgive the bill completely.
What is the average cost of an ambulance ride?
Ambulance bills can range from $200 up to $2,000+ depending on mileage, services performed, and your location. Expect to pay at least several hundred dollars.
Do hospitals ever cover ambulance bills?
In some cases, hospitals may pay ambulance bills for patients who require emergency transport but cannot afford it. However, this is decided on a case-by-case basis.
The Bottom Line on Paying Ambulance Bills
Ambulance transportation, while often medically necessary, can come at a steep price. If you are transported via ambulance, in most cases you will be responsible for paying the bill yourself. However, there are steps you can take to reduce the financial impact, from submitting claims to negotiating pricing. With the right approach, you may be able to lower your out-of-pocket ambulance bill costs.
What the law says
The federal No Surprises Act protects people from many types of out-of-network health care bills, including unexpected charges for ER services, air ambulances and most out-of-network care at in-network facilities.
Yet that law, passed by Congress in late 2020, doesnt address ground ambulances, an industry in which so-called balance billing — in which patients are charged the difference between the in-network and out-of-network rate — is the prevailing practice.
For instance, the law didnt prevent one family from getting hit with a $97,599 bill for an 86 mile air ambulance flight to San Francisco from Salinas, California, to get specialized care for a baby fighting for his life. Thats because health plans determine what care is “medically necessary,” and insurers get to define what that means in each case.
Another such case involved a rural Tennessee resident who died at 70 at Vanderbilt University Medical Center in Nashville last year, leaving being a early $82,000 air ambulance bill that her estate was expected to pay.
And, while 18 states have enacted protections against surprise ambulance billing, the laws only cover people in state-regulated insurance plans, with federal action needed to extend the protections to those with private employer-sponsored coverage, which is about 65% of the country.
Many communities contract EMT services from one provider, and unless it has an agreement with a persons insurer, the service would be 100% out of network, Kelmar said. Additionally, patients transported from one hospital to another are basically at the mercy of medical staff, who are not necessarily focused on what is covered by insurance.
Asked how to avoid such a scenario, Kelmar replied that “it may not be possible. If you call 911, they send who is available.” Indeed, she strongly advises that people get get the emergency care they need and then deal with the bills.
Get an itemized bill, then negotiate
But when consumers do get hit with an exorbitant ambulance bill, there are several steps people should take, Kelmar told CBS MoneyWatch.
1. Get an itemized bill. Thats essential for identifying and potentially challenging individual charges. Towns typically negotiate mileage rates, and if you find a community two miles down the road with a lower rate, you can suggest paying that rate instead.
2. Negotiate. It can be hard to get patients to pay for ambulance services, so if a person is willing to cover even a portion, some companies are willing to bargain.
“Talk about your financial situation, tell them, Im on this kind of budget, that Ive been out of work X number of days,” she said.
Ambulance providers are often willing to cut a deal, such as 40% off in a person pays by the end of the day, said Kelmar, who advised putting such charges on a high-interest credit card.
3. Make sure the bill went through insurance. Even out-of-network, insurance plans would pay a portion akin to a negotiated rate, so make sure that has occurred.
“In the course of an emergency, sometimes the ambulance doesnt get your insurance or the hospital is not forthcoming, so you want to verify that the bill has been run through insurance. Sometimes the ambulance bills you the very next day, so verify that this is the final bill,” Kelmar said.
4. Go back to your insurance company and ask them to pay more. “Thats also an important call to make,” Kelmar said. “Then you can tell the ambulance company you are trying to get them more money.”